Accumulation of fluid below a surgical wound appears after various types of surgery, especially after surgery for breast cancer. However, accumulations of fluid appears also frequently after vascular surgery, e.g. in the inguinal region. Patients with arthritis often have accumulation of fluid in there joints caused by the disease e.g. in the knees.
Furthermore, accumulations of fluid may appear in the lungs, around the heart, or as an abscess connected to any organ under the skin e.g. in case of infectious diseases.
Accumulations of fluid in the lungs or in the abdominal cavity also often appear in patients suffering from severe cancer. When emptying accumulations of fluid in such cases various systems are used today, inter alia just a hypodermic needle mounted on a syringe or various joint systems with three-way taps, hoses, hypodermic needles, drain tubes, catheters and syringes. If an outlet hose has been mounted, it is today often led to an open vessel (capsule, plastic, glass vessel) or a collection bag.
When the fluid has been removed, installation of other fluid can be an advantage. If the cavity is infected, rinsing by addition of saline and the subsequently remove it again is often recommended. By subsequent aspiration and rinsing this procedure results in a dilution of the residual volume and the bacteria therein.
Further, supply or injection of medicine, like cortisone after removal of fluid in a joint is a well-known procedure. When medicine has to be injected the dead volume of injection part has to minimal compared to the drug volume, in order to dose the medicine correctly.
Another example is injection of fluid or air to resolve a blockage in the needle, the drain tube or catheter.
When using a hypodermic needle on a syringe the emptying of the fluid is impeded, inter alia because the syringe, which is mounted on the hypodermic needle, needs to be removed several times with a view to emptying the fluid suctioned. If a three-way tap has been mounted, the said three-way tap needs to be alternated between suction and emptying position, simultaneously with the mounted syringe being actively pulled out in order to suck the fluid and subsequently being pushed in with a view to emptying the syringe through an outlet, which is generally led through some sort of hose to an open vessel (capsule, plastic! glass vessel) or a collection bag, e.g. of plastic. Finally, the outlet hose must also be handled in relation to the outlet. When emptying fluid after breast surgery (seroma collection) it is often advantageous to be two persons. One of the persons performs the suction by holding the plunger handle of the syringe out whilst the other person uses the hand to move the fluid towards the spot, where the hypodermic needle has penetrated the skin. Outside this the assistant can ensure that the collecting hose is kept in a right position. The procedure done by two persons allows a more complete emptying without penetrating the skin several times and thus limits the risk of infection.
The procedures, as it is generally performed today, for emptying fluid or air from cavities below skin level can be divided into:
A. Hypodermic Needle Mounted on a Syringe
1. Introducing the hypodermic needle into a cavity with fluid or air.
2. Fixing the puncture needle in a certain position and often with a certain desired depth of the needle tip below the skin.
3. Pulling back the plunger handle of the syringe with a view to filling the syringe with fluid/air from the cavity.
4. Separating the syringe and the hypodermic needle.
5. Emptying the contents of the syringe into the collection vessel (capsule, plastic/glass vessel)
6. Assembling the hypodermic needle and the syringe again.
7. Repeating the suction of fluid or air from the cavity.
8. Repeating the procedure in item 3-7 until all fluid or air has been sucked from the cavity.
B. Hypodermic Needle Mounted on a Syringe with a Three-Way Tap
1. Introducing the hypodermic needle into a cavity with fluid or air.
2. Fixing the puncture needle in a certain position with a certain depth of the needle tip below the skin.
3. Pulling back the plunger handle of the syringe with a view to filling the syringe with fluid/air from the cavity.
4. Turning the three-way tap away from initial position. Pushing down the plunger handle of the syringe in order to empty the contents of the syringe into the collection vessel: capsule, plastic/glass vessel, or collection bag.
5. Turning the three-way tap back to initial position with a view to repeating the procedure as mentioned in item 3-5.
6. Repeating the procedure in tem 3-5 until all fluid or air has been sucked from the cavity below the skin.
These procedures may be difficult to perform by a single person, especially when the system has to be separated when performing the procedures. (A item 3-7). This may result in incomplete emptying of fluid or air as well as non-observance of the aseptic procedure, e.g. backflow of fluid or air from the hypodermic needle into the cavity, with a subsequent higher risk of infections. In addition, handling of the evacuated fluid in open vessels is both unhygienic and unpleasant for the patients to experience.
The procedure for emptying and rinsing of the cavity below skin level, as it is generally performed today, is as follow:
C. Hypodermic Needle, a Syringe and a Saline Bag Mounted on with a Three-Way Tap:
1. Turn the three-way valve such that there is connection between the needle and syringe and closed for the saline inlet.
2. Introducing the hypodermic needle into a cavity with fluid or air.
3. Fixing the puncture needle in a certain position with a certain depth of the needle tip below the skin.
4. Pulling back the plunger handle of the syringe with a view to filling the syringe with fluid/air from the cavity.
5. Separating the syringe and the hypodermic needle.
6. Emptying the contents of the syringe into the collection vessel (capsule, plastic/glass vessel)
7. Assembling the hypodermic needle and the syringe again.
8. Repeating the suction of fluid or air from the cavity.
9. Repeating the procedure in item 3-7 until all fluid or air has been sucked from the cavity.
10. Turning the three-way tap away from initial position onto a position where there is connection between the saline bag and needle.
11. Open the tubing clamp on the saline tubing line a let saline into the cavity.
12. Repeat the procedure 1 to 9.
13. Repeating the procedure item 1-12 until an appropriate rinsing of the cavity has been obtain, typically observed when the removed fluid is clear.
Patients with arthritis have often fluid accumulation in their joints. This fluid is often removed to relief pain and to prevent further fluid accumulation injection of medicine, eg cortisone is often added.
The procedure for emptying and adding medicine of the cavity below skin level, as it is generally performed today, is as follow:
D. Hypodermic Needle, a Empty Syringe and Syringe with Medicine:
1. Assemble the needle and empty syringe.
2. Introducing the hypodermic needle into a cavity with fluid or air.
3. Fixing the puncture needle in a certain position with a certain depth of the needle tip below the skin.
4. Pulling back the plunger handle of the syringe with a view to filling the syringe with fluid/air from the cavity.
5. Separating the syringe and the hypodermic needle.
6. Emptying the contents of the syringe into the collection vessel (capsule, plastic/glass vessel)
7. Assembling the syringe with medicine on the hypodermic needle
8. Inject the medicine
9. Remove needle
Improved clamping devices are needed also in other types of medical appliances, such as in irrigation systems for rectal irrigation, bladder irrigation and the like.
The documents U.S. Pat. No. 4,053,135, U.S. Pat. No. 4,643,389, U.S. Pat. No. 6,196,519, U.S. Pat. No. 3,419,245, U.S. Pat. No. 4,369,951, U.S. Pat. No. 2,309,302, U.S. Pat. No. 5,230,704 and U.S. Pat. No. 4,435,170 disclose examples of known tube clamps. However, these are all complicated to use and produce, and/or provide inadequate clamping.